Hemiplegic migraine is a rare genetic form of migraine that can mimic symptoms of a stroke, but does not cause permanent damage. Diagnosis involves genetic testing and a physical exam, and treatment includes preventive medication and acute medication during severe episodes.
A hemiplegic migraine is considered a rare genetic form of migraine disease. Sufferers of hemiplegic migraine not only experience the traditional symptoms that a migraine induces, but additional symptoms that can mimic those associated with a stroke. Treatment for this inherited condition is usually two-pronged and consists of preventive medications prescribed for the long term and acute medications given during severe episodes.
Considered a complex medical condition, the onset of a migraine is usually preceded by warning signs. Individuals who suffer from migraines can experience changes that affect hearing, vision and speech. Those who experience symptoms associated with migraine with aura usually suffer from more pronounced visual abnormalities. For individuals who have hemiplegic migraine, the signs and symptoms can be more debilitating, culminating in a general lack of coordination and control. During severe episodes, the individual may experience temporary paralysis on one side of their body.
Fortunately, although the symptoms associated with hemiplegic migraine can be quite intense, there is no risk of permanent neurological or physical damage. The manifestation of symptoms depends on the individual and can vary from episode to episode. Sufferers of hemiplegic migraine may experience symptoms that can include severe pain on one side of the head, slurred speech, and dizziness. Additional symptoms indicative of an episode may also include confusion, sensory sensitivity, and lack of coordination. The onset of symptoms can be gradual and potentially last as little as an hour or several days.
Individuals experiencing symptoms that may be indicative of a hemiplegic migraine may undergo a variety of tests to confirm a diagnosis. Available since 2006, genetic testing is a relatively new option for determining whether an individual has the genetic mutation associated with hemiplegic migraine. Those whose genetic tests confirm the existence of the mutation are diagnosed with familial hemiplegic migraine (FHM). Individuals whose test results are negative are diagnosed with sporadic hemiplegic migraine (SHM).
A complete physical exam is usually conducted along with a thorough medical history review. Because the symptoms associated with this form of migraine can mimic those of stroke, additional tests such as magnetic resonance imaging (MRI) or a computed tomography (CT) scan may be conducted. Additional tests may include evaluations of your blood vessels, carotid artery, and heart to rule out any secondary conditions, such as a blood clot.
Prevention is the first step in treating hemiplegic migraine. It is imperative that people who receive a confirmed diagnosis educate themselves about the disease and the role of treatment in managing symptoms. An anticonvulsant, calcium blocker, or other supplements may be recommended to reduce the recurrence and severity of the episode. Acute episodes can be treated with nonsteroidal anti-inflammatory drugs (NSAIDs), selective narcotic central nervous system depressants, or analgesics and antinausea drugs to relieve symptoms. Severe episodes may require intravenous administration of magnesium sulfate, verapamil, or valproic acid (VPA).
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